• Manage multiple healthcare client accounts, providing oversight and direction to offshore delivery teams leveraging new technologies to build secure and digital experiences for patients, providers, payers, and life sciences software vendors and ensuring high customer satisfaction• Build and maintain technical trusted advisor relationships with clients’ influential operational and technical decision makers for the successful adoption of emerging technology trends, tools and services

• Managed team of program and project managers supporting integrated healthcare system IS division technology and clinical initiatives, annually facilitated 600+ project intake and senior leadership governance process, lead project lifecycle development and operational activities in support of functional team members and stakeholders, and oversaw project reporting hub• Lead team of project managers and technicians in the budgeting, provisioning, and deployment of $40M+ annually of IS hardware assets in support of new builds, expansions, joint ventures, partnerships, and acquisitions• Oversaw IS team supporting $7.3M+ asset store, 30K+ package shipping/receiving department, and 12K+ hardware net-new/replacement program to annually support system-wide infrastructure, increasing productivity and enhancing user experience• Established business best practices aligned to corporate strategy joining financial, contractual and inventory functions to support life cycle management of IS hardware including budgeting, sourcing, provisioning, monitoring, deploying, retiring, and recycling

• Coordinated with major national healthcare client operations and IT teams to evaluate strategic business options and technology capabilities, define and monitor program scope areas, create functional future state business processes and technical architecture blueprints, manage multiple project release timelines, and implement communication and governance plans across Medicare, Medicaid, and Commercial lines of business• Supported Program Management functions within state-based healthcare exchanges by actively engaging multiple payers in IT readiness and integration activities for Qualified Health Plans, Stand-alone Dental and Small Business Health Options• Developed, implemented and managed payer IT coordination activities associated with systems development life cycle (impact analysis; application design; schedule development; risk, issue, and action item tracking; and testing activity coordination) for Open Enrollment, Renewal and ongoing enrollment operations• Directed enrollment operations and reconciliation support to maintain payer alignment with EDI standards and state-specific exchange policy implementation• Clients included: Humana, Anthem, Kaiser Permanente Colorado, Kentucky Office of Health Benefit and Information Exchange (kynect), Health Care Services Corporation (HCSC), State of Rhode Island Unified Health Infrastructure Project (RIBridges), Molina Healthcare, Brookdale Senior Living

• Subject matter expert in the areas of Provider Networks, Contract Pricing, Capitation, Finance, and Authorizations• Implemented, maintained and audited Xcelys/Peradigm/DIAMOND 950 claims applications • Partnered with clients to assess current work environments, define business requirements, analyze approaches, and translate operational needs into system terms• Utilized a broad depth of healthplan operational experience and technical expertise to design and deploy strategy for optimal implementation results while minimizing disruption of day-to-day productivity• Developed and implemented standard procedures and protocol to ensure knowledge transfer and system efficiency• Provided interface design and data mapping for EDI transactions and third-party applications• Conducted product demonstrations, functional overviews and end-user training to ensure accurate and effective utilization of the systems• Clients included: Kaiser Permanente California, Harvard Pilgrim Health Care, Community Health Plan of Washington, North American Medical Management, WellPoint, New West Health Services, Massachusetts Health Connector, Neighborhood Health Plan, AmeriChoice

• Created and produced financial decision support packages to evaluate new and renegotiated contracts for hospitals, physician groups and ancillary providers to optimize reimbursement terms• Collaborated with contracting team to design reimbursement models that could be effectively automated in the system to reduce manual claim process, maximize system efficiency, reduce appeals/grievances, and improve financial performance• Identified, organized and managed process improvement opportunities and problem solving activities across multiple areas including Claims, Finance, Medical Management, and Membership • Assessed, designed, implemented, and monitored contract workflow process to assure consistent interpretation, configuration and audit of provider contracts • Managed team of analysts supporting configuration and maintenance of the AMISYS Provider subsystem • Subject matter expert on CMS reimbursement methodologies, billing and regulations with responsibility to educate staff• Designed and implemented usual and customary fee schedules for physicians and ancillary providers

• Developed and implemented sound configuration methodology and testing processes to maximize system functionality in support of organizational goals• Designed and led system reconfiguration project to support financial reporting• Created and orchestrated pricing reconfiguration and workflow improvements to increase clean claim pass-through rate and reduce pended claims• Collaborated with IT concerning production processes, data integrity, reporting requirements, and business process integration• Identified, organized and managed process improvement opportunities and problem solving activities across multiple operational areas including Claims, Finance, Medical Management, Membership, and Provider Contracting• Managed and trained team of analysts and specialists supporting configuration and maintenance of the AMISYS managed healthcare system• Established protocols for provider subsystem audit to increase operational productivity